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Liz Joyce looks a glittering picture of health — a strong, slender frame hardened by countless miles of running and toughened by hours of kick-boxing and lifting weights.

It’s what you’d expect from someone making their living as a personal trainer.

There’s the tattoo on the shoulder, a handshake firm enough to crush walnuts and the concentrated, restless energy of someone who’s never quite sure where the stopping point is until it’s reached.

“Outwardly I look super healthy,” said Joyce who runs Joyce Training at 234 West 11th Ave in Vancouver.

“But five years ago I was diagnosed as having inflammatory bowel disease.”

Joyce is one of the 250,000 Canadians who suffer from this cruel and potentially fatal condition which is painful and life-altering — the physical trauma compounded by the stress and constant worrying of where the nearest toilet might be.

“When I’m flaring I have 10 to 15 seconds max to find a toilet. It can happen anywhere. I could be out walking, be in the middle of a store. You just don’t know when it’s going to happen. It’s really scary,” she said.

Canada, for reasons not understood, has one of the highest rates of inflammatory bowel disease (IBD) in the world. There are two main forms of IBD — Crohn’s Disease and ulcerative colitis — and the direct and indirect costs to the economy each year in treatment and loss of productivity due to absence from work is $1.8 billion, according to the Canadian Digestive Health Foundation.

“We still don’t know what causes it. I was 24-years old when I got the first symptoms and it progressed to full blown ulcers throughout my large intestine,” she said.

Joyce remembers awakening from a colonoscopy and being shown pictures of massive, bleeding ulcers in her intestines.

“The doctor told me I was really sick and when I looked at the pictures I realized how people could die from this. It was shocking. I’d never been sick before. Nobody knows why this happens so I guess I just drew the short straw.”

Joyce, 29, suffered for four years until she went into remission over a year ago. She is being treated with oral medicines and Remicade, an intravenous drug that is infused every eight weeks.

She also uses vitamins and herbal supplements such as Curcumin, an anti-inflammatory remedy that is extracted from turmeric.

“That’s the one thing outside my medication that put me into remission. I was really healthy after that,” she said.

During those four years it was a struggle to continue working as a fitness coach.

“In some ways I was lucky because my flare-ups happened mostly in the morning so I worked afternoons,” she said.

Her advice to anyone just diagnosed with IBD is the learn all they can about the disease and to be their own advocate when it comes to treatment.

“You have to maintain your own health. You can’t just leave it to your doctor. You have to stay on top of when you are going to see your doctor, when the test results are coming in, what medications you are on. Research that stuff and have a list of questions for your doctor.

“Being involved in my health care brought a huge sense of relief and so I find the whole process less stressful,” she said.

“And the most important thing — monitor what you are eating.

“When I went to see a doctor for the first time he said just eat what doesn’t bug you and that’s really bad advice. You have to look for those staple foods that are gentle on your system. If a normal person has a reaction to something they’ve eaten it could last for a couple of hours. For me I will be a mess for four or five days.

“So eat safe foods for one or two weeks then add different things one at a time. If something new bugs you let your system settle down then try something else,” she said.

She can’t tolerate milk or any vegetables that have a hard shell such as beans or corn or soya beans.

“I eat small safe meals that don’t overload my system. They need to be nutrient dense, not large in volume, so I’ll eat brown rice and chicken breasts and a banana or apple which keeps me going for three hours then I can eat again,” she said.

On the days when the disease makes its presence felt she cuts back on exercising.

“I have to curb my competitive nature and just chill out do a relapse workout such as some light biking. On my good days I can go for broke and make up for the bad days,” she said.

“I’d also advise people to stay away from the Internet chat rooms. It’s sick people sitting at home talking about how bad things are and you can really get into a downward spiral of bad news and it’s overwhelming.”

“You have to concentrate on how to relax. I read books or go for a walk to allow my body to de-stress. I’m a girl so doing things that don’t make me feel like a sick person — getting my hair done or a manicure. It seems like small things but when you’re not well it’s quite welcome.“One of the best things I did was getting involved in volunteering with the CCFC (Crohn’s and Colitis Foundation of Canada). I’ve made friends with people who have my condition and we get together and if I’m having a bad day at least I’m out living my life not letting it run me behind a computer screen.”

However, she’s recently noticed signs of an impending flare up which worries her.

“No matter how good you are feeling you’re always waiting for the other shoe to drop. I hope with help from my doctor I’ll get healthy again within a month, who knows maybe it will be six months. I’m doing everything I can think of to avoid another flare up and have researched the heck out of it to help my body battle this. That’s the thing about the disease, it’s got a mind of it’s own and it’s so unpredictable.”

“But for everyone who is going through this I want to tell them that at some point you will be OK. Just remember it’s not always going to feel as bad as it does on your bad days.

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